Efeitos do programa de capacitação para o desempenho ocupacional (opc) com crianças brasileiras com transtorno do espectro autista (tea) e suas famílias: estudo de viabilidade

Abstract

Autism or Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder in which the most common and evident signs are characterized by a singular triad: deficits in communication (verbal and non-verbal), social interaction and restricted and repetitive behaviors. The autistic child may have different and/or delayed development compared to children of the same age without the disorder. Difficulties in the course of development unfold in different crossings not only in the daily life of the child, but also of their families, especially the primary caregivers. When considering that parents/caregivers are responsible for their children and have a great influence on their daily lives and performance, they are critical figures for the good development and rehabilitation of these children. In this sense, the "Occupational Performance Coaching" (OPC), translated into Brazilian Portuguese as "Capacity for Occupational Performance", appears as a proposal of Occupational Therapy that aims to improve occupational performance in the areas identified as goals and increase the capacity of caregivers to manage future challenges in occupational performance. This study aimed to investigate the feasibility of using OPC in the Brazilian population. Initially, the proposal was to study the effects of the program in groups carried out in person, however, with the establishment of the pandemic caused by the new Coronavirus (COVID-19) at the beginning of the study, it was necessary to reformulate the project design and adapt to the remote format, with individual assistance. Thus, online and individual meetings were held, which took place a time a week lasting sixty minutes or more, depending on the demands of each family/child. Convenience sampling was used, and 36 children were initially selected on the waiting list of the Sensory Integration Laboratory (LAIS) of the Federal University of Minas Gerais (UFMG). After analyzing the inclusion criteria, 6 families were selected, but one abandoned the program after the 3rd session and another stated, after starting the program, that the diagnosis of ASD was not yet closed, therefore it did not meet an essential inclusion criteria for participation in the research and received therapeutic assistance parallel to the program. The 4 families of autistic children aged between 3 and 5 years and 6 months were evaluated with the instruments Autism Classification System of Functioning: Social Communication (ACSF: SC), Parental Sense of Competence Scale - PSOC and Canadian Occupational Performance Measure - COPM, all were answered by the parents. After evaluation through online forms, each family participated in up to 10 intervention sessions using the OPC protocol. The sense of parental competence scale resulted in a decrease in the final score of 2 families, maintenance of the final score of 1 family and an increase in the final score of 1 family. The average performance and final satisfaction showed a minimum of 4.25 and a maximum of 6.33 for performance, and a minimum of 2.5 and a maximum of 7 for satisfaction. Hypotheses were raised to justify the decrease in the sense of parental competence after the intervention. The results indicate that the OPC is viable for use in the Brazilian population, achieving significant clinical improvement in performance and satisfaction of intervention goals, in addition to providing the development of transfer and/or generalization skills.